2019 -- S 0773 SUBSTITUTE A

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LC002138/SUB A

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO HEALTH AND SAFETY - SEPSIS PROTOCOLS

     

     Introduced By: Senators Pearson, Lynch Prata, and McCaffrey

     Date Introduced: April 04, 2019

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Chapter 23-17 of the General Laws entitled "Licensing of Health-Care

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Facilities" is hereby amended by adding thereto the following section:

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     23-17-65. Protocols for the early recognition and treatment of patients with severe

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sepsis/septic shock.

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     (a) For purposes of this section, the following words and terms shall have the following

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meanings:

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     (1) "Sepsis" means a life-threatening organ dysfunction caused by a dysregulated host

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response to infection.

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     (2) "Septic shock" means sepsis with persisting hypotension and having a serum lactate

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level >2 mmol/L despite adequate volume resuscitation.

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     (b) On or before February 1, 2020, the director of health shall develop in coordination

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with the Antimicrobal Stewardship and Environmental Cleaning task force, and make available to

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health care practitioners, information on best practices for the treatment of patients with sepsis

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and septic shock. The best practices shall be based on generally accepted standards of care,

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including, but not limited to:

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     (1) An evidence based screening tool that can be used at initial evaluation of adult and

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pediatric patients in the emergency department;

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      (2) An evidence based treatment protocol for adult and pediatric patients that includes

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time-specific treatment goals;

 

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     (3) Nurse-driven testing protocols to enable nurses to initiate care for patients with

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suspected sepsis;

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     (4) Incorporation of sepsis screening and treatment tools into the electronic health record

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where possible;

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     (5) Mechanisms to prompt escalation of care within the facility, and, when appropriate, to

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stabilize and transfer to a facility able to provide a higher level of care;

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     (6) Strategies for appropriate hand-offs and communication regarding the care of patients

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with sepsis and for the reassessments of patients at regular intervals;

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     (7) Hospital specific antibiotic guidelines for use in treating patients with sepsis and a

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mechanism for reevaluating a patient’s antibiotic treatment based on culture results that provides

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reassessment and de-escalation of antibiotic treatment when appropriate; and

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     (8) Staff education on sepsis policies and procedures during the onboarding process and

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at least annually or when new practice guidelines are published or existing standards are updated

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to ensure that care reflects current standards of practice.

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     (c) In order to enhance patient safety and protection, each hospital and freestanding

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emergency-care facility licensed in the state shall implement policies and procedures in

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accordance with the best practices issued by the department of health.

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     (d) Beginning on February 1, 2021, the department of health shall not issue or renew a

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license unless the applicant is in compliance with this section.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY - SEPSIS PROTOCOLS

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     This act would require hospital medical staff to adopt, implement, periodically update

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and submit to the director of health, evidence-based protocols for the early recognition and

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treatment of patients with sepsis and septic shock ("sepsis protocols" that are based on generally

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accepted standards of care).

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     This act would take effect upon passage.

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